U-M researchers estimate more than 229,000 American children currently have diabetes; of those children, one-third are obese

ANN ARBOR, Mich. – Childhood obesity can carry with it some heavy health risks that often last well into adulthood – heart disease, high blood pressure and depression, to name a few.

Obese children also are twice as likely to have diabetes than children who are of normal weight, according to a new study from the University of Michigan Health System.

The study, published in the February issue of Diabetes Care, is the most recent national study to estimate the prevalence of children with diabetes. It found that more than 229,000 children – approximately 3.2 cases for every 1,000 American children under the age of 18 – currently have diabetes. And one-third of those children are obese.

The study, was conducted by researchers with the Child Health Evaluation Research (CHEAR) Unit in the Division of General Pediatrics at the U-M C.S. Mott Children’s Hospital. It is based on data from the National Survey of Children’s Health (NSCH), a population-based household telephone survey sponsored by the Maternal and Child Health Bureau, the National Center for Health Statistics, and the Centers for Disease Control and Prevention.

As children’s waistlines have continued to grow so has concern that obesity will lead to even more children developing diabetes before they’ve graduated from high school. And caring for the combination of these children’s diabetes and obesity may place more strain on the health care system, says study lead author Joyce Lee, M.D., with the Division of Pediatric Endocrinology and CHEAR Unit at U-M.

"Among school-aged children, obese children have a greater than twofold chance of having diabetes, compared with children of normal weight,” says Lee.

“The large number of children with diabetes in the U.S., and the potential for increasing numbers of children developing diabetes with the obesity epidemic, has serious implications for how these children will receive appropriate health care now and as they grow into adulthood.”

For their study, Lee and her colleagues used a sub-set of information gathered from NSCH interviews with the parents and guardians of 102,353 children from January 2003 through July 2004.

As part of the interviews, the parents and guardians were asked if their child’s health care professional had ever told them that their child has diabetes.

The children were grouped into three categories based on their body mass index, or BMI: not overweight, overweight and obese. BMI was calculated using the height and weight of the child reported by his parent or guardian.

Children with a BMI above the 85th percentile for their age and sex are classified as overweight, while those with a BMI above the 95th percentile are considered obese. For example, a 10-year-old boy of average height would be defined as obese if he weighed approximately 101 pounds or greater, says Lee.

These data provided researchers with evidence of an association between childhood obesity and diabetes. The study found that children ages 6 to 11 and ages 12 to 17 who were obese were more than twice as likely to have diabetes than children of the same age who were of normal weight.

The study estimates that nationally, 229,240 children have diabetes. Prevalence of diabetes was higher among older children, and the disease was more common among non-Hispanic white children than non-Hispanic black or Hispanic children.

While one form of diabetes, type 2, is usually associated with obesity, data used for this study did not distinguish between the two types.

Still, results point to a greater need for public health strategies to curb childhood obesity and reduce the number of children with diabetes, says Lee.

“These data create cause for concern, especially with a nationwide shortage of specialists who care for children with diabetes,” notes Lee. “From a clinical, public health and health resources perspective, we need to address childhood obesity head-on to help reduce the future burden of diabetes in the U.S.”

In addition to Lee, Melissa L. McPheeters, Ph.D., MPH; and James G. Gurney, Ph.D., with the CHEAR team in the U-M Division of General Pediatrics; and William H. Herman, M.D., MPH, with the Department of Internal Medicine at the U-M Medical School and the Department of Epidemiology at the U-M School of Public Health, co-authored the study.

The study was funded by a National Institutes of Health Pediatric Health Services Research Grant.

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